Hikikomori: psychopathology and differential diagnosis of a condition with epidemic diffusion

Martinotti, Giovanni; Vannini, Chiara; Natale, Chiara Di; Sociali, Antonella; Stigliano, Gianfranco; Santacroce, Rita; Giannantonio, Massimo Di

doi:10.1080/13651501.2020.1820524

Cited by 13 publications

(13 citation statements)

References 49 publications

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“…From a psychopathological perspective, video gaming might be adopted as a coping strategy in order to cope with stressful conditions and comorbidities [21, 22], in an attempt to escape from reality [23, 24], or the need to manage relationship problems including social withdrawal (e.g., Hikikomori; [25, 26]). People with IGD may have several comorbid mental health problems, such as depression, anxiety, social phobia [22, 27, 28], attention deficit and hyperactivity disorder [19, 29, 30], obsessive-compulsive disorder [31, 32], psychoticism, and neuroticism [33].…”

Section: Introductionmentioning

confidence: 99%

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults

Carlo

Verrastro²,

Alessi

et al. 2023

Eur Addict Res

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Introduction: Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming. Methods: Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18–40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R). Results: High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives. Discussion and Conclusion: The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.

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Section: Introductionmentioning

confidence: 99%

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults

Carlo

Verrastro²,

Alessi

et al. 2023

Eur Addict Res

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“…Further, they demonstrated that participants in a condition at risk of developing hikikomori reported higher symptoms of psychopathology than those not at risk of hikikomori. In light of the above findings and considering the increasing public health and scientific concerns around hikikomori in Italian adolescents [ 20 , 21 , 22 , 73 , 74 , 75 , 76 , 77 , 78 ], the first aim of the present study was to adapt the Italian version of the HQ-25 for adolescents and analyse its psychometric properties. The second aim was to explore the relationships between symptoms of hikikomori and the psychoticism personality domain of personality, symptoms of depression, anxiety, PIU, PLEs, and self-reported history of hikikomori to confirm the convergent validity of the HQ-25.…”

Section: Introductionmentioning

confidence: 99%

Psychometric Properties of the Italian Version of the 25-Item Hikikomori Questionnaire for Adolescents

Amendola

Presaghi

Teo

et al. 2022

IJERPH

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Hikikomori is a form of social withdrawal that is commonly described as having an onset during adolescence, a life stage when other psychiatric problems can also emerge. This study aimed to adapt the 25-item Hikikomori Questionnaire (HQ-25) for the Italian adolescent population, examining its psychometric properties; associations between hikikomori and psychoticism, depression, anxiety, problematic internet use (PIU), psychotic-like experiences (PLEs), to confirm convergent validity of the HQ-25; and the interaction effect between symptoms of hikikomori and PIU in predicting PLEs. Two-hundred and twenty-one adolescents participated in the study. Measures included the HQ-25, the Psychoticism subscale of the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, the Depression and Anxiety subscales of the Brief Symptom Inventory, the Internet Disorder Scale, and the Brief Prodromal Questionnaire. Data showed a satisfactory fit for a three-factor model for the HQ-25 that is consistent with the original study on the HQ-25. Three factors (socialization, isolation, and emotional support) were associated with psychopathology measures. Six participants reported lifetime history of hikikomori. Symptoms of hikikomori and PIU did not interact in predicting PLEs. This is the first study to validate the HQ-25 in a population of adolescents. Findings provide initial evidence of the adequate psychometric properties of the Italian version of the HQ-25 for adolescents.

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“…Clarification of the hikikomori type by comorbid psychiatric disorders is also vital for understanding the pathology and establishing treatment. Suwa and Suzuki (2013) classified hikikomori into primary hikikomori without comorbid psychiatric disorders and secondary hikikomori with comorbid psychiatric disorders for discussion of psychopathology, and many studies focused on the differences between them (Frankova, 2019; Martinotti et al, 2021; Suwa and Suzuki, 2013). Additionally, there is a suggestion that cases in which psychiatric disorders appear during prolonged hikikomori should be distinguished from secondary hikikomori as zeroth-order hikikomori (Sakai, 2012).…”

Section: Discussionmentioning

confidence: 99%

Who are hikikomori? Demographic and clinical features of hikikomori (prolonged social withdrawal): A systematic review

Nonaka

Takeda

Sakai

2022

Aust N Z J Psychiatry

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Objective: This review, which was registered with PROSPERO (CRD42021237988), aimed to systematically extract common elements in the hikikomori definition or criteria applied by researchers and examine cultural differences and chronological changes in the demographic characteristics of hikikomori individuals such as age, gender and hikikomori duration. Method: For inclusion in the review, the hikikomori criteria, age and gender of the hikikomori individuals had to be specified, and the article had to be peer-reviewed and written in Japanese or English, focusing on hikikomori individuals or their families. Case studies, reviews and qualitative studies were excluded. Results: The total sample size for the 52 studies included in the review was 4744. Over 80% of the studies included the elements ‘not working or attending school’, ‘not socializing outside one’s home’ and ‘duration of hikikomori’ in their hikikomori criteria, and many studies included the element ‘staying at home on most days except solitary outings’. A cross-temporal meta-analysis showed the possibility that the age of hikikomori individuals increased chronologically (β = 0.44, B = 0.50, 95% confidence interval = [0.16, 0.84]). Comparisons weighted by sample size between Japan and other countries showed the possibility that the age of hikikomori individuals was higher ( d = 0.32), the percentage of males was lower ( d = 0.91) and the hikikomori duration was shorter ( d = 2.06) in studies conducted in countries other than Japan. However, many of the included studies had a high risk of selection bias, and this bias may have influenced the results obtained. Thus, the results of this study may represent the researcher’s perception of hikikomori rather than accurately representing the actual condition of hikikomori. Conclusion: Researchers should specifically identify similarities and differences in the clinical picture of hikikomori and compare the studies to organize the findings derived from studies focusing on hikikomori.

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Hikikomori: psychopathology and differential diagnosis of a condition with epidemic diffusion

Cited by 13 publications

References 49 publications

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults

High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults

Psychometric Properties of the Italian Version of the 25-Item Hikikomori Questionnaire for Adolescents

Who are hikikomori? Demographic and clinical features of hikikomori (prolonged social withdrawal): A systematic review

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